CARDIOVASCULAR DISEASE (CVD)

FACTS:
• CVD made up 16.6 million, or one-third, of global deaths in 2001.
• Around 80% of CVD deaths took place in low and middle-income countries.
• By 2010, CVD will be the leading cause of death in developing countries.
• At least 20 million people survive heart attacks and strokes every year; many require
continuing costly clinical care.
• Heart disease has no geographic, gender or socio-economic boundaries.

CARDIOVASCULAR DISEASE: diseases and mortality in developed countries, and a

PREVENTION AND CONTROL
An estimated 16.6 million - or one-third of total global
deaths - result from the various forms of cardiovascular
disease (CVD), many of which are preventable by action on
the major primary risk factors: unhealthy diet, physical
inactivity, and smoking. More than 50% of the deaths and
disability from heart disease and strokes, which together
kill more than 12 million people each year, can be cut by a
combination of simple, cost-effective national efforts and
similar pattern is emerging as the CVD epidemic matures
in developing countries. The time lag effect of risk factors
for CVD means that the full effect of past exposure to
behavioural risk factors, especially among children, will
only be seen in the future. Unless preventive and
management efforts are embraced worldwide, the global
burden of CVD death and disease will continue to rise.
ESTIMATED DEATHS ATTRIBUTED TO
CARDIOVASCULAR DISEASES, 2001

individual actions to reduce major risk factors such as high OTHER CVDs
blood pressure, high cholesterol, obesity and smoking. (3.9 MILLION)

HEART DISEASES
And these are no longer only diseases of the developed (7.2 MILLION)
CEREBROVASCULAR
world: some 80% of all CVD deaths worldwide took place DISEASE
in developing, low and middle-income countries, while (5.5 MILLION)

these countries also accounted for 86% of the global CVD

TOTAL CVD DEATHS: 16.6 MILLION
disease burden. It is estimated that by 2010, CVD will be
the leading cause of death in developing countries.

WHY IS THIS HAPPENING?

EXTENT OF THE PROBLEM
The rise in CVDs reflects a significant change in diet habits,
physical activity levels, and tobacco consumption worldwide
The Major CVDs include:
as a result of industrialization, urbanization, economic
• Coronary (or ischaemic) heart disease (heart attack) development and food market globalization. People are
• Cerebrovascular disease (stroke) consuming a more energy-dense, nutrient-poor diet and are
• Hypertension (high blood pressure) less physically active. Imbalanced nutrition, reduced
physical activity and increased tobacco consumption are
• Heart failure
the key lifestyle factors. High blood pressure, high blood
• Rheumatic heart disease cholesterol, overweight and obesity - and the chronic
disease of type 2 diabetes - are among the major
Of the 16.6 million deaths from CVDs every year, 7.2
million are due to ischaemic heart disease, 5.5 million to
WHO REGIONS CARDIOVASCULAR DISEASE, DEATHS BY AGE, 2000
cerebrovascular disease, and an additional 3.9 million to
hypertensive and other heart conditions.As well, at least 20 AFR (1.0m) 45-59 60-69 70-79 80+
million people survive heart attacks and strokes every year,
AMR (2.0m) 45-59 60-69 70-79 80+
a significant proportion of them requiring costly clinical
care, which puts a huge burden on long-term care EMR (1.0m) 45-59 60-69 70-79 80+
resources.
EUR (5.0m) 45-59 60-69 70-79 80+

CVD affects people in their mid-life years, undermining the SEAR (3.8m) 45-59 60-69 70-79 80+

socioeconomic development, not only of affected WPR (3.7m) 45-59 60-69 70-79 80+
individuals, but families and nations. Lower socieconomic
25% 50% 75%
groups generally have a greater prevalence of risk factors,

WO R L D H E A LT H O R G A N I Z AT I O N

GLOBAL STRATEGY ON
DIET, PHYSICAL ACTIVITY AND HEALTH
 CARDIOVASCULAR DISEASE (CVD)

biological risk factors. Unhealthy dietary practices include EFFECTIVE INTERVENTIONS

the high consumption of saturated fats, salt and refined
carbohydrates, as well as low consumption of fruit • In the United Kingdom, a government-promoted
and vegetables.These risk factors tend to cluster. program in consort with the food and drink
manufacturing industry successfully reduced salt
content in almost a quarter of manufactured foods over
WHAT CAN BE DONE? several years.
Those who have already had heart attacks and strokes are • In Mauritius, cholesterol reduction was achieved
at high risk of recurrences and death. This risk can be largely by a government-led effort switching the
substantially lowered with a combination of drugs - statins main source of cooking oil from palm to soya bean oil.
for cholesterol lowering and low-doses of common blood • Korea has worked to retain elements of the traditional
pressure lowering drugs and aspirin - given daily to people diet. Civil society and government initiatives led mass
at elevated risk of heart attack and stroke. media campaigns to promote local foods, traditional
cooking methods and the need to support local farmers.
However, the most cost-effective methods of reducing • In Japan, government-led health campaigns have greatly
risk among an entire population are population-wide reduced general salt intake and together with increased
interventions, combining effective policies and broad blood pressure treatment have reduced blood pressure
health promotion policies. These should be be the first to population-wide. Meanwhile stroke rates have fallen by
be considered in all settings. In many countries, too much more than 70%.
focus is being placed on one-on-one interventions among
• In Finland, community-based and national interventions,
people at medium risk for CVD. A better use of resources
including health promotion and nutrition interventions,
would be to focus on those at elevated risk and to use other
led to population-wide reductions in cholesterol and
resources to introduce population-wide efforts to reduce
other risks, closely followed by a precipitous decline in
risk factors through multiple economic and educational
heart disease and stroke mortality.
policies and programs. These risk factors include diet and
physical activity. The dietary intake of fats, especially their • In the USA, a decrease in saturated fat intake in the late
quality, strongly influences the risk of CVD like coronary 1960s began the large decline in coronary heart disease
heart disease and stroke, through effects on blood lipids, deaths seen in the last few decades there.
thrombosis, blood pressure, arterial function, arrythogenesis • In New Zealand, introduction of labelling logos for
and inflammation. Excess salt has a significant impact on healthier foods led many companies to reformulate
blood pressure levels. their products. The benefits included large decreases in
the salt content of processed foods.
Compelling evidence indicates that at least three dietary
strategies are effective in preventing CVD, and in helping
manage the disease:
• Substitute nonhydrogenated unsaturated fats (especially
polyunsaturated fat) for saturated and trans-fats;
• Increase consumption of omega-3 fatty acids from fish
oil or plant sources;
• Consume a diet high in fruits vegetables, nuts and
whole grains, and low in refined grains.
• Avoid excessively salty or sugary foods.
• At least 30 minutes of regular physical activity daily
• Avoid smoking
• Maintain a healthy weight.

KEY CONTACTS DR P. PUSKA DR S. MENDIS Mr D. PORTER

World Health Organization World Health Organization World Health Organization
Tel: +41-22-791 4703 Tel: +41-22-791 3441 Tel: +41-22-791 3774
Fax: +41-22-791 4186 Fax: +41-22-791 4151 Fax: +41-22-791 4186
Email: puskap@who.int Email: mendiss@who.int Email: porterd@who.int